Training farce for nurses, doctors

Natasha Wallace

AUSTRALIA needs to train 7000 more nurses and hundreds more doctors every year for the next 15 years, says a shelved government report, even though cash-strapped hospitals already struggle to give existing students crucial experience with patients.

The landmark report, obtained by the Herald under freedom of information laws, highlights a Catch-22: it calls for a big increase in university places but institutions are unable to take many more students because they cannot provide vital hospital training.

Produced by the joint state-federal National Health Workforce Taskforce, the report forecasts how many extra places are needed each year to train enough doctors and nurses to serve the population by 2025, and for allied health professions by 2030.

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But figures in the Health Professional Entry Requirements 2009-2025 - Macro Supply and Demand Report effectively call for a 27 per cent jump next year on the 26,578 nursing places, a tripling of paramedic students and about a 10 per cent increase in undergraduate doctors.

It also predicts ''significant'' shortages in optometry (362 needed each year) and podiatry, which needs to more than double its undergraduates by adding an extra 271 places each year.

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However, experts say it is very unlikely that the increases will ever eventuate - even if the Government funds all the new places.

To meet the extra 356 medical places suggested each year until 2025, two new medical schools would have to open every year, Jim Angus, the president of Medical Deans, Australia and New Zealand, said.

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''It's a phenomenal increase. These are serious figures and we need to know how we're going to meet it. It's a wake-up call,'' Professor Angus said.

The report said there would be a shortage of 8154 doctors next year.

But Professor Angus said the system had reached its limit with a dramatic influx of graduate doctors from next year as numbers double by 2012 to 3430.

The largest increase recommended is for 7131 more nurse places - 5319 a year for registered nurses and 1812 for enrolled nurses - because of an expected exit rate of 85 per cent of the graduate intake by 2025 due to retirement.

That is nearly seven times the extra 1100 training places already funded by the Rudd Government - even though universities took up only 200 of the 500 extra places offered in 2008.

The report forecast a shortage next year of 11,822 nurses.

Jill White, Dean of the Sydney Nursing School at the University of Sydney, said the Government had known for a while that universities were unable to take more students because of the lack of access to patients in the courses.

''What we need to do is open up more clinical training places in the public and private sector,'' Professor White said.

She said it was likely the Government would fund the extra places suggested by its taskforce, knowing that the universities were unable to take up the offers because of the shortage of clinical placements in hospitals. ''They'll probably offer them knowing they won't be taken up. It's a significant frustration for everyone.''

The report says a whopping 1412 extra training places for paramedics are needed every year until 2030, on top of the present intake of 450.

Occupational therapy, social work and psychology have short-term surpluses though the report still recommends extra places of 167, 1323 and 1359 respectively. Some 80 extra dentist undergraduates are needed each year to head off a projected shortfall of at least 800 by 2020.

Dr John Buchanan, director of the Workplace Research Centre at the University of Sydney, said that increasing places was ''the easy part'' and the system basically needed more senior staff to train recruits.

''They don't have the capacity to actually develop people on the job. It's particularly acute in emergency departments," Dr Buchanan said.

The federal Health Minister, Nicola Roxon, would not be drawn on whether she would take her taskforce's advice on numbers or explain why the report had not been released since it was conditionally endorsed by the states in July.

''The issues raised by the report, and its public release, are currently being considered by all health ministers,'' Ms Roxon said.

She said the Federal Government had invested more than $1 billion in training, including increasing clinical placements for nurses.